特殊临床表现的脑梗死患者近期再发卒中风险研究

THE RESEARCH OF THE RECURRENT RISK OF STOKE IN PATIENTS WITH ACUTE CEREBRAL INFARCTION WITH SPECIAL CLINICAL SYMPTOMS

目的分析以短暂性脑缺血发作(TIA)为特殊临床表现的急性脑梗死患者再发卒中相关因素,并评价ABCD2卒中评分量表联合磁共振检查对此类特殊临床表现的脑梗死患者再发卒中风险的预测价值。方法收集2014年1月—2016年10月在该院神经内科住院的以TIA为临床表现的急性脑梗死患者72例,随访患者7 d及90d内缺血性卒中复发率,分析卒中复发的相关危险因素,以及复发情况与磁共振血管成像(MRA)结果和ABCD2评分数值的关系。结果以发作性症状为特殊临床表现的急性脑梗死患者7d及90d内脑梗死的再发率分别为6.9%和11.1%。磁共振检查血管存在明显狭窄(≥50%)的患者7d和90d内脑梗死的发生率较血管无明显狭窄(<50%)明显增高。ABCD2评分预测7d及90d内脑梗死复发风险分层能力,采用曲线下面积(Area Under the Curve AUC)值来评定预测效度,二者分别为0.805、0.768。结论磁共振血管成像(MRA)检查能较好的预测患者7d及90d内再发脑梗死风险,ABCD2量表评分对7d及90d内脑梗死再发有一定的预测价值,而二者联合对90d内脑梗死复发率预测价值更高。

Objective To analyze the correlative factors of recurrence of stoke in patients with acute cerebral infarction with clinical symptoms like TIA,and to predict the recurrence of stoke by MRA and ABCD2 clinical scale.Methods We collected 72 cases inpatients with acute cerebral infarction with clinical symptoms like TIA, and analysed the risk factors, made a follow- up visit about the recurrence of stoke within 7 days and 90 days.The relationship of the outcome of disease,MRA and ABCD2 clinical score was analyzed. Results The recurrence rate of stoke within 7 days and 90 days were 6.9 % and 11.1%.The patients with positive results of MRA bad higher recurrence rate of stoke within 7 days and 90 days.The AUC of ABCD2 score for 7 days and 90 days were 0.805 and 0.768.Conclusion MRA can be used to assess the recurrenct risk of stoke within 7 days and 90 days,ABCD2 clinical score combined with MRA were of great value for 7 days and 90 days pre- diction.